New Therapies for the Treatment of Spastic Cerebral Palsy

Background: Cerebral palsy is a heterogeneous condition associated with a non-progressive lesion, but permanent disorder of movement with limited mobility. It is generally associated with gross motor developmental delay. In moderate to severe cases motor developmental milestones such as walking may never be achieved. There are no specific therapies for cerebral palsy, and treatment of spastic cerebral palsy is generally aiming at improving mobility through muscle relaxation and physiotherapy. This is a retrospective observational study describing the treatment of spastic cerebral palsy with individualized treatment plans providing a new combination of interventions including nutritional support, muscle relaxants and the use of oral pyritinol, intramuscular piracetam, citicoline (oral and injectable), intramuscular cerebrolysin, and intramuscular nandrolone decanoate. Treatment aimed primarily at improving motor development particularly standing and walking. Patients and Methods: During the year 2018, six patients (3 girls and 3 boys) with spastic cerebral palsy and marked motor disability were treated. The patient age ranged from 22 months to three years. All patients were unable to stand or walk, and had poor speech development. Four patients (Patients 1, 4, 5, and 6) had severe cerebral palsy and were even not able to sit. The other two patients had moderately severe disorder and were unable to stand or walk. All the patients were not saying any word or were saying only few words. Results: After treatment, all the patients experienced improvement in motor development without the occurrence of any side effect. Five patients were able to stand with support (patients 1,2,3,4, and 5), and four of them were also able to walk few steps with support. The sixth patient remained unable to stand and the limited benefit of treatment was attributed to some degree of deformity and muscle contracture. In all patients treatment was associated with initiation of speech development or improved speech. It was possible to demonstrate improvement in fine motor skills in three patients (Patient 2, 3, and 5). Conclusion: The treatment of patients with spastic cerebral palsy (moderate and severe) with this individualized treatment plans was associated with a beneficial effect on motor development particularly standing and walking.